Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $104.71	Facility		$72.44	$72.44	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $72.44 / $100.00	Professional		$48.98	$72.44	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $128.82	Facility		$91.20	$91.20	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $162.18 / $204.17	Professional		$91.20	$162.18	$204.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $134.90 / $144.54	Professional		$109.65	$134.90	$144.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $147.91 / $616.60	Facility		$77.62	$147.91	$616.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $74.13 / $204.17	Professional		$54.95	$74.13	$204.17
Midlands Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $131.83 / $173.78	Professional		$125.89	$131.83	$173.78
Midlands Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $190.55 / $190.55	Professional		$131.83	$190.55	$190.55
United Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $75.86 / $186.21	Facility		$44.67	$75.86	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $57.54 / $109.65	Professional		$56.23	$57.54	$109.65
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $112.20 / $112.20	Professional		$89.13	$112.20	$112.20